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First 1 000 Days initiative promotes mother and child healthcare

01 November 2024 | Story André Damons | Photo Supplied

Dr Nomakhuwa Tabane is the Head of the Department of Paediatrics and Child Health at the University of the Free State.

The first 1 000 days of a baby’s life, from conception to the age of two, constitute a critical period during which children’s brains form as many as 1 000 neural connections every second – a pace that will not be repeated in their lifetime.

These connections are the building blocks of every child’s future, which makes the role of a campaign like the First 1 000 Days vitally important. It highlights the importance of stimulation and learning from the earliest possible moments, good nutrition for expectant mothers, prevention of malnutrition of children, and early diagnosis of chronic, life-threatening illnesses and developmental disorders.

This is according to Dr Nomakhuwa Tabane, Head of the Department of Paediatrics and Child Health at the University of the Free State (UFS). The campaign was promoted by Dr Tabane’s department in partnership with the Mother and Child Academic Hospital (MACAH) Foundation. The annual campaign kicks off on 1 November each year.

“There are certain factors that can interfere with this process and result in irreversible damage to children’s brain development, poor growth, and compromised immunity. Those conditions include prematurity, ischaemic brain damage, and infections. These are also the top contributors to the neonatal mortality.

“In the one-month to 49-month-old period, the causes of mortality and morbidity that affect brain development and growth include respiratory illnesses like pneumonia, diarrhoeal diseases, and malnutrition,” says Dr Tabane.

Aims of the campaign

The First 1 000 Days initiative promotes excellent mother, infant, and child healthcare by supporting community-based programmes that drive the message of the importance of the first 1 000 days of life to teenagers, young adults, healthcare workers, and the public. This initiative aims to bring about interventions that can address the Under-5 Mortality Rates (U5MR), including Neonatal Mortality Rates (NMR), Infant Mortality Rates (IMR), and Perinatal Mortality Rates (PMR).

“The campaign also aims to improve the growth and development of children in their first 1 000 days of life from conception until they are two years old. It also aims to improve expectant mothers’ health and prevent and decrease maternal mortality in the Free State, as well as to prevent unwanted pregnancies, focusing on decreasing teenage pregnancies.”

According to Dr Tabane, the 2020 South African UN Inter-agency Group for Child Mortality Estimation (UNIGME) estimate for U5MR was 32 deaths per 1 000 live births, NMR of 11 per 1 000 live births, and infant mortality rate (IMR) of 26 per 1 000 live births as compared to the Medical Research Council (MRC) estimate of U5MR of 28 per 1 000 live births, NMR of 12 per 1 000 live births and IMR of 21 per 1 000 live births (15).

South Africa behind other BRICS countries

Based on the 2020 UNIGME report, says Dr Tabane, South Africa has achieved the Sustainable Development Goals (SDG) goals of NMR and the U5MR. South Africa’s indicators were much better than the UNIGME and the MRC 2020 estimates, but it still falls behind other BRICS countries.

“In contrast to other BRICS countries (Brazil, Russia, India, China, and South Africa), UNIGME reports that in the same reporting period of 2020, China’s U5MR was seven per 1 000 live births, Brazil's 15 per 1 000 live births, and Russia's five per 1 000 live births (16). In 2020, the South African national in-hospital neonatal mortality rate (NMR) based on DHIS data was 12,0 per 1 000 live births; the infant mortality rate (IMR) was 15.1 per 1 000 live births, and the under-5 mortality (U5 MR) rate was 16.9 per 1 000 live births, with differences amongst provinces,” says Dr Tabane.

The first 1 000 days campaign’s interventions include education to prevent illnesses and deaths and promote good health, growth, and development. While many training programmes on child survival strategies have been rolled out (e.g., MSSN, HBB, ETAT, AANC, ESMOE, and IMCI), in-service training still has significant gaps.

Other interventions include preventing unwanted and unplanned pregnancies, providing healthcare support for therapeutic and interventional care, strengthening the implementation of the existing strategies developed by the Department of Health to reduce Maternal and Child Mortalities, and monitoring and evaluating the interventions.

News Archive

Inaugural lecture explores the compatibility of commercial certainty and constitutionalism

2015-10-15

From the left: Prof Caroline Nicholson,
Prof Elizabeth Snyman van Deventer,
Justice Malcolm Wallis and Dr Lis Lange.

Justice Malcolm Wallis presented his inaugural lecture, entitled “Compatibility of commercial certainty and constitutionalism”, to the Faculty of Law on 17 September, 2015. The occasion was attended by faculty staff, students, and senior members of the Bloemfontein judiciary.

In her welcoming remarks, Prof Caroline Nicholson, Dean of the Faculty of Law at the UFS, expressed the immense pride the faculty has in hosting such an occasion, and the remarkable work of Justice Wallis in the South African legal fraternity over his forty-year career.

Justice Wallis spoke of the constitution’s important role in ensuring that the law in commercial matters is enforced fairly without the prejudice or undue influence from the desire to obtain or preserve personal advantage. “Try, if you can, to conceive of a society in which commercial relationships are enforced and enforceable purely as a matter of discretion. Ask yourselves: how would such a society function?” he said.

He reiterated that the role and the rule of law is to guide and protect parties in commercial transactions. It has considerable impact on society in how it is enforced. “Commercial disputes may seem to involve only the parties to the proceedings, but when they involve significant changes to established commercial law, their impact is inevitably wider. Such changes affect other agreements, other relationships, underlying financing transactions, and, in our modern world, contracts of insurance and reinsurance. The latter at least will always have an international dimension,” he said.

He explored specific judgements and the role the concept of “Ubuntu” played in delivering them, the fair enforcement of commercial law, and how this should be an integral part of South African law under the constitution.

In closing, Justice Wallis stated that “in principle, the existence of a constitution and constitutional rights need not destabilise commercial law, or the reasonable expectations of business people.”

Justice Wallis has received numerous accolades locally and internationally during his long career, including his appointment as a Professor Extraordinary in the Department of Mercantile Law at the University of the Free State in 2014.

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